[Chronic disseminated intravascular coagulation  in a case of ventricular aneurysm. Correction by low-dose heparin].
A case of intravascular coagulation in a patient with a very large ventricular aneurysm is reported. Biological signs of defibrination with a low serum fibrin of 0,80 g/1, thrombocytopaenia of 80,000/mm3 and the presence of soluble complexes and FDPs were detected after recurrent haematuria. Low dose heparin (0,15 to 0,20 ml x 2/day by subcutaneous injection) led to normalisation of the fibrinogen levels, increased the platelet count and reversed the consumptive coagulopathy. Each withdrawal of heparin (5 attempts over 16 months) led to a biological relapse. At the final withdrawal of therapy, the biological abnormalities remained minor; the consumption of fibrinogen and platelets was well compensated. Similar cases have been published in aortic aneurysms with and without dissection, but the association with a cardiac aneurysm has not been reported previously. The physiopathological mechanism of the coagulopathy is discussed and the authors suggest routine study of the coagulation system in all patients with cardiac aneurysms. This case illustrates the efficacity of moderate doses of heparin in a patient with "biological hypercoagulability" well documented by laboratory investigations.
D002908:Chronic Disease; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006322:Heart Aneurysm / Q000150:complications*; D006352:Heart Ventricles; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged
D006493:Heparin
Coagulation intravasculaire disséminée chronique dans un cas d'anévrysme ventriculaire.